Remote bednet use monitoring to describe patterns of use and exposure to female Anopheles mosquitoes in an Ugandan cohort

Background Long lasting insecticide-treated bednets (LLINs) are the most widely used tool for preventing malaria. There has been a plateau in progress highest burden African countries since 2015, leading to questions about effectiveness of LLINs. In this study, remote LLIN use monitors were deployed cohort Eastern Uganda explore how interacts with mosquito exposure. Methods The SmartNet study included 20 households from May October 2019. devices recorded, every 15 min, whether an was unfurled or folded up. Unannounced visits assess accuracy. Risk factors associated poor assessed using generalized linear equations. Female Anopheles exposure estimated by combining hourly probabilities human landing catches and measures density biweekly CDC light traps participants rooms. Mosquito averted LLINs quantified measurements age-related differences equations, adjusting relevant covariates household clustering. Results 96 individuals contributed 5,640 observation nights. 126 unannounced visits, had area under curve 0.869 classifying up down. rate non-use 13.5% nights (95% CI: 12.6–14.3%). Compared children 5, 1.8 times higher 1.6–2.1; p < 0.001) 5–15 years 2.6 2.2–3.1; aged 15– <30years. no difference between 5 adults > 30 years. 50.3% female 40.0–60.0%), decreasing point estimates efficacy across age groups: 61.7% 42.6–80.7%) 48.0% 29.1–66.8%) over 30. Conclusions Objective accurate can feasibly be obtain data use. provided protection only 50% dependent upon age. assessing role malaria prevention it is crucial consider dynamics behaviors.